Source · Select Committees · Public Accounts Committee
Recommendation 25
25
Accepted
NHSE's needed capital investment in technology is diverted to mitigate ICB spending deficits.
Conclusion
NHSE assesses that sustained increases in capital investment are needed to replace ageing equipment, expand capacity to meet demand, and enable staff to benefit from new technologies.48 However, NHSE told us its investment in technology between 2022–23 and 2024–25 could have been greater had it been able to use underspend against its central budgets for that purpose, but it had to use those underspends instead to mitigate ICBs’ spending deficits.49
Government Response Summary
The government agrees that sustained increases in capital investment are needed, states that no further capital-to-revenue transfers will be used due to fiscal rules, and highlights that a record £13.6 billion has been agreed for capital investment in health for 2025-26.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. Recommendation implemented: October 2024 2.8 Decisions to switch CDEL to RDEL have previously been made, in line with the principles set out in ‘Consolidated Budgeting Guidance’ and in agreement with HM Treasury, to meet financial pressures and protect frontline care. 2.9 The fiscal rules set out by the Chancellor at the Autumn Budget 2024 mean that no further capital-to-revenue transfers will be used. The department and NHSE welcome the Chancellor’s decision not to allow further capital to revenue switches and recognise the importance of capital investment in the NHS in delivering an effective and productive healthcare system. 2.10 In 2025-26, record levels of capital investment into health have been agreed, with a budget of £13.6 billion. Excluding years affected by the Covid-19 pandemic, this settlement represents the highest DHSC capital budget in real terms since 2010. 2.11 The NHS has lived within its overall budget in every recent financial year. NHS systems must now agree credible operational and financial plans for the year and deliver on those plans, under rigorous scrutiny and oversight from Ministers, DHSC and NHS England.